CT Scanning is strongly recommended by The Royal College of Radiologists for the screening of occupational lung diseases such as silicosis instead of the traditional chest X-ray. There are also implications.
CT Scanning and Risk Detection
Silicosis on the Rise
Implications of the Study
The Royal Australian and New Zealand College of Radiologists have recommended the screening of workers for occupational lung diseases such as silicosis should be carried out using CT scans, rather than the currently used X-rays.
X-rays are failing to reliably detect lung disease in all workers, and RANZCR cited a study where 43% of workers with silicosis in particular, were overlooked during the standard X-ray testing.
The study was conducted with workers who were exposed to silica dust. The standard X-ray result showed that 43% of the tested workers had normal or healthy chest X-rays while the CT Scan showed otherwise.
RANZCR worried that X-ray testing for these workers failed to detect lung disease, the CT scans were far more reliable in the testing with greater sensitivity and accuracy.
Silicosis on the Rise
Lung diseases, including silicosis, are considered a danger to Australian’s health and the Morrison Government has committed funds to address them. A final report on this is expected by December 2020.
Silicosis has been called one of Australia’s next public health crisis. It is a lung disease with a particularly high prevalence among young tradies and where silica-containing dust is not controlled. It scars the lungs and causes progressive respiratory problems over time.
An example according to the Royal Australian College of Physicians, whereby one third (34%) of the workers in two Queensland stone masonry businesses were assessed had accelerated or complicated versions of silicosis.
The Work Health report showed that at least 22 workers’ compensation claims for silicosis were lodged in Queensland in the period between August to September 2018. Other cases have also been diagnosed in New South Wales and Victoria. However, figures about accelerated silicosis in Australia and New Zealand have not been captured.
The Australian Cancer Council also reports that more than 580,000+ Australian workers have been exposed to silicosis since 2011. Of those, it is estimated between 5000 to 6000 of those may develop lung cancer over the course of their life.
According to the Council, the occupations with the greatest exposure include Miners, Constructions Workers, Farmers and Engineers. Exposure to silica dust increases with the following work activities:
- Breaking, crushing or grinding material containing silica dust
- Sand blasting and/or casting
- Cement paving, surfacing or finishing
- Road construction
- Manufacturing of glass, ceramics, brick, concrete, tiles or metals
Implications of the Study
Workers with a risk of lung disease from harmful dust have access to free and subsidised X-rays scans with the government’s icare NSW screening clinic and the icare Lung Bus that travels around the state offering mobile screening.
More than 6500 workers in recent years have been screened by icare under the Dust Diseases scheme. The scheme also offer testing for other workplace diseases such as mesothelioma and asbestos.
Manager of the Industrial Relations (including Compensation) portfolio for the NSW Greens, worried the number of workers screened with the standard X-rays instead of CT scans was concerning.
The government is urged to invest in CT Scan technology for icare’s Lung Bus, which will be a comprehensive effort to conduct testing for workers who are already on the system.
A spokeswoman for icare NSW was positive and open to working with peak bodies and industry regulators including SafeWork Australia to act on the findings of the college.
It is strongly recommended that doctors and other medical professionals, especially also occupational nurses, should ask all patients from the building industry about their level of exposure to artificial stones and any silica dust.
If a patient has been exposed, medical professionals are advised to:
- Ask about any respiratory symptoms
- Assess the patient using chest x-ray and full lung function testing
- If the patient has worked in his or her industry for over 3 years, a high-resolution CT chest scan could be considered
- With any concerns, the patient should be referred to an occupational physician or respiratory physician for further assessmentQuestions?
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